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Introduction to

Harm ReductionJESS FEAR

FORENSIC MANAGER

SUMMITSTONE HEALTH PARTNERS

Harm Reduction Defined

Movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

Set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.

Reference: https://harmreduction.org/about-us/principles-of-

harm-reduction/

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https://harmreduction.org/about-us/principles-of-harm-reduction/

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Harm Reduction….

Accepts, for better and or worse, that licit

and illicit drug use is part of our world and

chooses to work to minimize its harmful

effects rather than simply ignore or

condemn them.

Reference: https://harmreduction.org/about-us/principles-of-

harm-reduction/

Harm Reduction in every day life

Driving your car

Individual Level:

REGULATION: We educate and regulate drivers themselves

Driver’s education

Licensing tests

Periodic renewals

Laws: encourage safer driving choices

Seatbelt

Texting

Drug/Alcohol Use

System Level: We manage and design systems to increase safety

Safer roads

Safer cars

Speed limits

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https://harmreduction.org/about-us/principles-of-harm-reduction/

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State Wide Harm Reduction Efforts

Syringe Service Programs

Naloxone Education and Distribution

Lift the Label Campaign

Smoking Cessation

HIV/HCV testing, services and treatment

PrEP

Fentanyl testing strips

Condoms

Medication Assisted Treatment

Why Harm Reduction ?

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Why Harm Reduction

Cost Diversion

Connection to Treatment

Support Health

Support long term recovery

Charlotte Ledonne, RN, BSN, MA, LPC SLV Area Health Education Center

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What is SHARRP

◦A community partnership following the

harm reduction model to address

access to care, community resources

and safer use.

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Community partners

◦Alamosa County Health Department

◦Conejos County Health Department

◦Costilla County Health Department

◦Rio Grande County Health Department

◦SLV Area Health Education Center

◦SLV Behavioral Health Group

◦Valley Wide Health Systems

Additional Collaborators

◦CDPHE

◦The Children’s Hospital

◦Colorado Health Network

◦SLV Health

◦Rio Grande Hospital

◦Rocky Mountain Counseling Center

◦Crossroads Turning Points

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Services offered at SHARRP◦ HIV/HCV Testing monthly- The Children’s Hospital outreach

◦ Basic physical assessment- VWHS

◦ Referral for medical services and insurance eligibility evaluation- VWHS

◦ Referral for MAT- VWHS and SLVBHG

◦ Syringe access and exchange

◦ Condoms

◦ Naloxone- OBH

◦ Fentanyl testing strips

◦ Additional Services- Hep A vaccinations- Alamosa Department of Health

Data 1/31/2020 N=387

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Naloxone Use Report 1/31/2020

◦Narcan Nasal has been administered 99 times since February 2018 in single or double doses.

◦Clients report calling 911 35% of the time

◦Clients reported staying with the person 100% of the time

◦Clients did not report any fatalities.

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Referrals to SLV PartnersClient referrals are made to VWHS staff located at SHARRP for:

◦ Wound assessment including abscesses

◦ Insurance eligibility

◦ Access to inpatient substance abuse treatment

◦ MAT

◦ Assessment and treat of medical concerns and conditions

Client referrals are made to SLV Behavioral Health Group for:

◦ MAT

◦ Therapy

◦ Psychiatric services

Client referrals are made to Crossroads Turning Points for:

◦ Methadone treatment

◦ Therapy

◦ Detox prior to MAT

Client Comments

Clients shared that SHARRP has helped them by:

◦disposing [needles] appropriately

◦ lowering risk of diseases

◦helping with awareness on drug abuse and desire

◦knowing I am safe

◦preventing HCV and HIV

◦getting medical attention, do not feel embarrassed

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◦We have been approved by the Rio Grande Board of Health to start a new program in Rio Grande County. We are currently working with our partners in that county for a tentative start up date in April/May, 2020.

◦Discussions continue in two other counties of the San Luis Valley to open harm reduction sites there.

◦Consider partnerships for harm reduction programs in your areas.

THANK YOU FOR YOUR INTEREST IN RURAL

COMMUNITIES

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Hospital and Syringe Access Provider Collaboration

Lessons Learned and Tips for SuccessAmanda Wroblewski, LCSW, Boulder Community Health’s Opioid and Chronic Pain Response Program

&

Madeleine Evanoff, Boulder County Public Health’s Works Syringe Access Program

Overview of Programs

BCH OCPRP

• Service navigation & short-term case management

• Bridge between client, community and healthcare system

• Supporting education for community and healthcare staff about Substance Use Disorders and recovery

• Resources and referrals to community partners

BCPH The Works

• Safer injection, smoking and snorting drug supplies

• Health education – wound care, vein care, overdose prevention and drug testing

• Rapid HIV and hepatitis C testing

• Street outreach and education

• Safe disposal of used syringes

• Resources and referrals to community partners

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A Purpose For Partnership• Treatment referrals are most successful with warm handoffs

• Referrals can accomplish one stop shop medical care – PCP, MAT, mind/body resources, all in one

• BCH representatives on street outreach, bringing healthcare to the person, breaking down barriers to care and treatment

• Syringe access providers have built trust with clients, clients trust their referrals to treatment programs

• Pooling of resources can make reaching clients easier and more effective

• Open communication and collaboration fights silo-ed medical care and creates transparency

• ED Suboxone induction starts at the syringe access clinic, bus tickets provided, care advocate on site at hospital

Cost/Benefit

Cost

• Time

• Relationship building• Hospital/SAP

• Local tx centers for ongoing care

• Potentially resources• Access to transportation or other

logistical needs

Benefit• Better access to treatment for clients

• Builds client trust in medical care • Easier and faster referral process

• Low barrier ED inductions

• Increased recognition of treatment program through outreach initiatives

• Greater comfort level accessing treatment for those who may need services

• Lower instance of repeated ED visits

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Results/Story Time

• 3 Suboxone inductions in BCH ED for clients of The Works

• The Works client, in early recovery, got connected to OCPRP who funded body work intervention to assist with continued harm reduction and sobriety maintenance.

Leave with a Task/How to

Pick one item to do during the next month:

• Visit your closest syringe access program for a tour

• Introduce yourself to a harm reduction staff member and discuss healthcare barriers for clients

• Attend a community meeting that focuses on substance use disorder and/or harm reduction

Ask questions to gain insight on how to…

• Partner for street outreach

• Develop a care continuum between agencies

• Increase trust of service in people who use drugs

• Increase warm handoff referrals from syringe access programs

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